Rho激酶抑制剂法舒地尔对微血管心绞痛患者的疗效观察

Effects of Rho kinase inhibitor(fasudil) in patients with microvascular angina

目的观察Rho激酶抑制剂法舒地尔对微血管心绞痛患者的疗效及其对血管内皮功能的影响。方法选取50例微血管心绞痛患者,分为常规药物治疗组(A组)25例,法舒地尔联合常规药物治疗组(B组)25例;另外,选择20名健康体检者为对照组(C组)。治疗2周后对比A、B组的疗效,以及比较A、B两组用药前、后血清中内皮素-1、一氧化氮(nitric oxide,NO)的浓度,同时和正常人血清中的炎性因子做对照。结果 (1)治疗前:A、B组每周心绞痛的发作次数、运动至心绞痛的时间及心绞痛的持续时间比较,差异无统计学意义(P>0.05)。(2)治疗后:A、B组患者心绞痛症状均得到改善,B组治疗总有效率80.00%,优于A组52.00%,差异有统计学意义(P<0.05);A、B组心绞痛发作次数、运动至心绞痛出现的时间以及心绞痛的持续时间与治疗前比较,差异均有统计学意义(P<0.05);A、B组之间上述指标比较,差异有统计学意义(P<0.05);B组男、女之间上述指标比较,差异无统计学意义(P>0.05)。(3)治疗前:A、B组血清内皮素-1浓度均较C组高,NO浓度均较C组低,差异均有统计学意义(P<0.01);A、B组之间血清内皮素-1、NO浓度比较,差异无统计学意义(P>0.05)。(4)A、B组治疗后血清内皮素-1浓度均较治疗前降低,NO浓度均较治疗前升高,差异有统计学意义(P<0.01)。(5)B组治疗后血清内皮素-1浓度低于A组,NO浓度高于A组,差异有统计学意义(P<0.01)。结论法舒地尔通过影响内皮素-1和NO的表达,改善微血管心绞痛患者的血管内皮功能,进而改善其心绞痛症状,提高运动耐量。

Objectives To study the effects of Rho kinase inhibitor（fasudil） on vascular endothelial function in patients with microvascular angina. Methods Fifty patients with microvascular angina were randomly divided into conventional treatment group（group A, n =25） and Rho kinase inhibitor（fasudil） treatment group（group B, n =25）.At the same time, 20 cases of healthy people were selected as control group（group C, n=20）. Curative effects of group A and group B in two weeks were compared. Besides, serum concentrations of nitric oxide（NO） and endothelin-1（ET-1） before（groups A, B, C） and two weeks after（groups A, B） treatment were compared. Results（1） There was no significant difference in weekly anginal attack rates, movement duration of angina pectoris and duration of angina pectoris between groups A and B before treatment（P〉0.05）.（2） Symptoms of angina pectoris of groups A and B were improved and the total effectiveness rate was obviously higher in fasudil therapy group（80.00%） than in conventional therapy group（52.00%） after two weeks（P〉0.05）; There were significant differences in terms of weekly anginal attack rates, movement duration of angina pectoris and duration of angina pectoris after treatment in groups A and B（P〈0.05）; They also had significant differences between the two groups（P〈0.05）; However, there was no statistically significant difference in the indexes above between men and women in group B（P〉0.05）.（3） Serum concentrations of NO were lower but serum concentrations of ET-1 were higher in groups A and B than in group C before treatment（P〈0.01）; There was no significant difference in serum concentrations of NO and ET-1 between groups A and B before treatment（P〉0.05）.（4） Serum concentrations of NO increased but serum concentrations of ET-1 decreased in groups A and B after treatment（P〈0.01）.（5） Serum concentration of NO was higher but serum concentration of ET-1 was lower in group B compared with group A after treatment（P0.01）. Conclusions Fasudil can improve vascular endothelial function in patients with microvascular angina and affect the expressions of NO and ET-1. It can improve symptoms and exercise tolerance of patients with microvascular angina.